Respiratory hospitalizations of children living near a hazardous industrial site adjusted for prevalent dust: A case–control study

Air quality disparities and respiratory health risks in critically polluted and relatively non-polluted areas: a prospective child health study

BACKGROUND

Air pollution, a significant global health concern, notably impacts human well-being. Children, owing to their distinctive physiology and behavior, are particularly susceptible to its adverse effects. This prospective study examines air quality variations and respiratory risks in children residing in critically polluted areas (CPA) compared to relatively non-polluted areas (NPA), utilizing a prospective design to understand the impacts of air pollution on children's respiratory health, including measures like relative risk (RR) and attributable risk (AR).

METHODS

This prospective study tracked 739 students of 5th- 7th grade residing in CPA and NPA for one year, and measured the ambient and indoor air quality levels in both these areas. Throughout the study, based on the observed respiratory symptoms new episodes of upper and lower respiratory tract illnesses were recorded for each child on a weekly basis. Incidence rate, RR and AR for both the illnesses were compared. Statistical analysis was performed with SPSS 26.0.

RESULTS

The study observes higher concentration for particulate matter and gaseous pollutants at CPA in comparison to NPA. Children living in CPA exhibited a notably greater weekly occurrence of both upper and lower respiratory tract illnesses compared to those in NPA, with RR of 1.26 (95% CI: 1.16-1.37) and 1.74 (95% CI: 1.34-2.27), respectively. The AR associated with air pollution for upper and lower respiratory tract illnesses among CPA students was found to be 20.7% and 42.7%, respectively.

CONCLUSION

This research underscores the pressing need to address air pollution in critically polluted areas and its profound effects on children's respiratory health. Public health interventions, such as reducing emissions from industries and creating green spaces, should be prioritized. Furthermore, early respiratory health screening in schools within polluted areas could aid in the timely diagnosis and management of respiratory issues in children.

Relationship between Wildfire Smoke and Children’s Respiratory Health in the Metropolitan Cities of Central-Chile

Wildfire causes multiple problems for people living in cities. One of them is the deterioration of air quality as a result of wildfire smoke. This smoke can consequently have effects on human health. The present study aims to characterize the relationship between the occurrence of wildfires in central Chile and the effects on children’s respiratory health. Public databases provided the number of emergency care visits, wildfires, and concentration of air pollutants, demographics and meteorological variables for the regions of Santiago and Valparaiso from 2010 to 2013. Time series analysis was used monthly on health care visits to determine the relative health risk in children when in the presence of additional wildfires. Significant health risks were observed in Santiago for children younger than 1-year-old of bronchitis (RR 1.007, CI 95% 1.007–1.008; chronic lower respiratory diseases (RR 1.012, CI 95% 1.012–1.013); and pneumonia (RR 1.026 CI 95% 1.026–1.027) and in children aged one to four years old (RR 1.016 CI 95% 1.015–1.016). A dose-response relationship was also observed for pneumonia, showing that it affects younger children particularly when there is an increase in the number of wildfires. In the Region of Valparaíso, wildfires did not significantly change the risk of respiratory illness, this could be due to favorable ventilation. Currently, Santiago has an urgent need for monitoring and the evaluation of the damage to children’s respiratory health, along with the development of comprehensive prevention strategies.

Review of the effect of air pollution exposure from industrial point sources on asthma-related effects in childhood

We reviewed epidemiologic studies of the association between exposure to air pollution from industries and asthma-related outcomes in childhood. We searched bibliographic databases and reference lists of relevant articles to identify studies examining the association between children's exposure to air pollution from industrial point-sources and asthma-related outcomes, including asthma, asthma-like symptoms, wheezing, and bronchiolitis. We extracted key characteristics of each study and when appropriate we performed a random-effects meta-analysis of results and quantified heterogeneity (I ²). Thirty-six studies were included in this review. Meta-analysis was generally not possible and limited to a few studies because of substantial variation across design characteristics and methodologies. In case-crossover studies using administrative health data, pooled odds ratio (OR) of hospitalization for asthma and bronchiolitis in children <5 years were 1.02 [95% confidence intervals (CI): 0.96, 1.08; I ² = 56%] and 1.01 (95% CI: 0.97, 1.05; I ² = 64%) per 10 ppb increase in the daily mean and hourly maximum concentration of sulfur dioxide (SO₂), respectively. For PM_2.5, pooled ORs were 1.02 (95% CI: 0.93, 1.10; I ² = 56%) and 1.01 (95% CI: 0.98, 1.03 I ² = 33%) per 10 μg/m³ increment in the daily mean and hourly maximum concentration. In cross-sectional studies using questionnaires, pooled ORs for the prevalence of asthma and wheezing in relation to residential proximity to industry were 1.98 (95% CI: 0.87, 3.09; I ² =71%) and 1.33 (95% CI: 0.86, 1.79; I ²= 65%), respectively. In conclusion, this review showed substantial heterogeneity across study designs and methods. Meta-analysis results suggested no evidence of an association for short-term asthma-related effects and an indication for long-term effects, but heterogeneity between results and limitations in terms of design and exposure assessment preclude drawing definite conclusions. Further well-conducted studies making use of a longitudinal design and of refined exposure assessment methods are needed to improve risk estimates.

Respiratory symptoms, asthma and levels of fractional exhaled nitric oxide in schoolchildren in the industrial areas of Estonia

OBJECTIVES

Exposure to air pollutants in the ambient environment has been associated with various respiratory symptoms, and with increased asthma diagnosis, in both children and adults. Most research to date has focussed on core pollutants, such as PM₁₀, PM_2.5, SO₂ and NO₂, and less attention has been given to the effects of industry-specific contamination. The current study aimed to examine the associations between respiratory symptoms, asthma, increased levels of fractional exhaled nitric oxide (FeNO) (as a marker of eosinophilic airway inflammation) and ambient levels of industrial pollutants (such as benzene, phenol, formaldehyde and non-methane hydrocarbons) for schoolchildren living near oil shale industries in Ida-Viru County, Estonia.

METHODS

A total of 1326 schoolchildren from Ida-Viru, Lääne-Viru and Tartu Counties participated in a cross-sectional study, consisting of questionnaires on respiratory symptoms and asthma, as well as clinical examinations to measure FeNO. Dispersion modelling was used to characterize individual-level exposure to industrial air pollutants at each subject's home address. Associations between exposure and respiratory health were investigated using logistic regression analysis, and differences in results between regions were analysed using the Chi-squared test.

RESULTS

The prevalence of respiratory symptoms (p < 0.05) in children living near (i.e. within 5 km) of an oil shale industry site in Ida-Viru County was 2-4 times higher than in children living in the reference area of Tartu County. Children exposed to 1 μg/m³ higher levels of benzene and formaldehyde had a higher odds ratio (OR) of having rhinitis without a cold (OR 1.03, 95% confidence interval (CI) 1.01-1.06), of ever having had attacks of asthma (OR 1.05, 95% CI 1.01-1.10) and of having a dry cough a few days per year (OR 1.05, 95% CI 1.01-1.10). Children exposed to 1 μg/m³ higher levels of benzene, formaldehyde, phenol and non-methane hydrocarbons had a higher odds ratio of having high FeNO levels (≥30 ppb): OR and 95% CI of 1.05, 1.01-1.09; 1.22, 1.06-1.41; 1.01, 1.00-1.01; and 1.75, 1.75-2.62, respectively.

The mediating role of risk perception in the association between industry-related air pollution and health

Background

Heavy industry emits many potentially hazardous pollutants into the air which can affect health. Awareness about the potential health impacts of air pollution from industry can influence people’s risk perception. This in turn can affect (self-reported) symptoms. Our aims were to investigate the associations of air pollution from heavy industry with health symptoms and to evaluate whether these associations are mediated by people’s risk perception about local industry.

Methods

A cross-sectional questionnaire study was conducted among children (2–18 years) and adults (19 years and above) living in the direct vicinity of an area with heavy industry. A dispersion model was used to characterize individual-level exposures to air pollution emitted from the industry in the area. Associations between PM_2.5 and NO_X with presence of chronic diseases (adults) and respiratory symptoms (adults and children) were investigated by logistic regression analysis. Risk perception was indirectly measured by worries about local industry (0–10 scale). Mediation analyses were performed to investigate the role of mediation by these worries.

Results

The response was 54% (2,627/4,877). In adults exposure to modelled PM_2.5 from industry (per μg/m³) was related with reported high blood pressure (OR 1.56, 95% CI 1.13–2.15) and exposure to modelled NO_X (per μg/m³) was inversely related with cardiovascular diseases (OR 0.91, 95% CI 0.84–0.98). In children higher PM_2.5 and NO_X concentrations (per μg/m³) were related with wheezing (OR 2.00, 95% CI 1.24–3.24 and OR 1.13, 95% CI 1.06–1.21 respectively) and dry cough (OR 2.33, 95% CI 1.55–3.52 and OR 1.16, 95% CI 1.10–1.22 respectively). Parental worry about local industry was an important mediator in exposure–health relations in children (indirect effect between 19–28%).

Conclusion

Exposure from industry was associated with self-reported reported high blood pressure among adults and respiratory symptoms among their children. Risk perception was found to mediate these associations for children.

The effect of industry-related air pollution on lung function and respiratory symptoms in school children

BACKGROUND

Heavy industry emits many potentially hazardous pollutants into the air which can affect health. However, the effects of air pollution from heavy industry on lung function and respiratory symptoms have been investigated scarcely. Our aim was to investigate the associations of long-term air pollution from heavy industry with lung function and respiratory symptoms in school children.

METHODS

A cross-sectional lung function study was conducted among school children (7-13 years) in the vicinity of an area with heavy industry. Lung function measurements were conducted during school hours. Parents of the children were asked to complete a questionnaire about the health of their children. A dispersion model was used to characterize the additional individual-level exposures to air pollutants from the industry in the area. Associations between PM_2.5 and NO_X exposure with lung function and presence of respiratory symptoms were investigated by linear and/or logistic regression analysis.

RESULTS

Participation in the lung function measurements and questionnaires was 84% (665/787) and 77% (603/787), respectively. The range of the elevated PM_2.5 and NO_X five years average concentrations (2008-2012) due to heavy industry were 0.04-1.59 μg/m³ and 0.74-11.33 μg/m³ respectively. After adjustment for confounders higher exposure to PM_2.5 and NO_X (per interquartile range of 0.56 and 7.43 μg/m³ respectively) was associated with lower percent predicted peak expiratory flow (PEF) (B -2.80%, 95%CI -5.05% to - 0.55% and B -3.67%, 95%CI -6.93% to - 0.42% respectively). Higher exposure to NO_X (per interquartile range of 7.43 μg/m³) was also associated with lower percent forced vital capacity (FVC) and percent predicted forced expiration volume in 1 s (FEV1) (B -2.30, 95% CI -4.55 to - 0.05 and B -2.73, 95%CI -5.21 to - 0.25 respectively). No significant associations were found between the additional exposure to PM_2.5 or NO_X and respiratory symptoms except for PM_2.5 and dry cough (OR 1.40, 95%CI 1.00 to 1.94).

CONCLUSION

Exposure to PM_2.5 and NO_X from industry was associated with decreased lung function. Exposure to PM_2.5 was also associated with parents' reports of dry cough among their children.

Prediction of size-fractionated airborne particle-bound metals using MLR, BP-ANN and SVM analyses

Size-fractionated heavy metal concentrations were observed in airborne particulate matter (PM) samples collected from 2014 to 2015 (spanning all four seasons) from suburban (Xianlin) and industrial (Pukou) areas in Nanjing, a megacity of southeast China. Rapid prediction models of size-fractionated metals were established based on multiple linear regression (MLR), back propagation artificial neural network (BP-ANN) and support vector machine (SVM) by using meteorological factors and PM concentrations as input parameters. About 38% and 77% of PM_2.5 concentrations in Xianlin and Pukou, respectively, were beyond the Chinese National Ambient Air Quality Standard limit of 75 μg/m³. Nearly all elements had higher concentrations in industrial areas, and in winter among the four seasons. Anthropogenic elements such as Pb, Zn, Cd and Cu showed larger percentages in the fine fraction (ø≤2.5 μm), whereas the crustal elements including Al, Ba, Fe, Ni, Sr and Ti showed larger percentages in the coarse fraction (ø > 2.5 μm). SVM showed a higher training correlation coefficient (R), and lower mean absolute error (MAE) as well as lower root mean square error (RMSE), than MLR and BP-ANN for most metals. All the three methods showed better prediction results for Ni, Al, V, Cd and As, whereas relatively poor for Cr and Fe. The daily airborne metal concentrations in 2015 were then predicted by the fully trained SVM models and the results showed the heaviest pollution of airborne heavy metals occurred in December and January, whereas the lightest pollution occurred in June and July.

Increased incidence of allergic rhinitis, bronchitis and asthma, in children living near a petrochemical complex with SO2 pollution

This study aims to investigate incidence of allergic rhinitis, bronchitis and asthma, in children living near a petrochemical complex with SO₂ pollution obtained by air monitoring stations. A total of 587 children aged 11 to 14 were recruited and classified into high and low exposure groups based on a radius of 10km from the complex. To study the influence of health on children since the operation of complex in 1999 and observe the difference of these diseases' short-term and long-term impact, we obtained the incidence rates of allergic rhinitis (ICD-9: 477), bronchitis (490-491) and asthma (493) from the Taiwan Health Insurance Database for three periods: 1999-2002, 1999-2006, and 1999-2010. Since 2001, the mean and 99th percentile of SO₂ concentrations in the high exposure area have been significantly higher than those in low exposure area. There were significant differences between the high and low exposure groups in the percentage of smoking, alcohol consumption, passive smoking exposure and incense burning habits. The incidence rates of three intervals were 26.9%, 35.7%, 41.7%; 8.3%, 8.8%, 10.2%; 18.5%, 25.0%, 26.9% for allergic rhinitis, bronchitis and asthma in high exposure group. Significant differences were found between groups for allergic rhinitis in all periods, bronchitis in the first two periods, and asthma in the first period using Student's t-test. After we adjusted age, gender, group, living near roads, incense burning and passive smoking exposure, the hazard ratios between exposure groups were 3.05, 2.74, and 1.93 for allergic rhinitis with significant difference in three periods, and 2.53, 1.92 and 1.72 for bronchitis with significant difference in first period and 1.60, 1.28 and 1.29 for asthma with significant difference in first period by Cox regression. The higher incidence of allergic rhinitis was related to boys and living near roads and the higher incidence of asthma was also related to younger children, boys, and passive smoking exposure.